8w6d Scan - Heard heartbeat but couldn't see embryo

Hey, all. I'm hoping you ladies will have some insight for me, or maybe shared experiences. Thanks in advance.

A little backstory: at 6 weeks 2 days I was scanned by my infertility clinic, where we saw the little embryo and heard a healthy heartbeat of 119bpm. The clinic then released me to my regular OB.

Fast forward to yesterday, I went in for my scan at my OB's office. She used the vaginal probe and immediately found a healthy heartbeat (she would not tell me the bpm), but could only barely see the embryo and could not find its fetal pole for measuring purposes.

The OB tried guessing at the CRL a few times, but always came up with measurements that were too far behind, like 7w4d, when I was 8w6d. All we could see on the screen was a foggy, vague embryo shape - though strangely the yolk sac was crystal clear.

After several minutes she gave up, and I was told that if I wanted to see the embryo, I could make an appt with the specialty ultrasound dept, which has higher quality machines - but also demands out of pocket payments. After contacting the ultrasound department, I learned that there are no available appointments until Nov 30th!

So now I'm a little nervous.

Should I worry about my little bean not growing properly? Or is the healthy heart rate a better indicator of fetal viability than the CRL is? I've Googled this topic to death, and all I can ever find is info pertaining to embryos WITHOUT a heartbeat, and that's definitely not my problem.

I'm hoping you ladies will have some input on the matter, because I could really use some reassurance. Thanks again!

That sounds strange to me. I'm wondering if perhaps the OB doing the scan wasn't very experienced and didn't know what they were looking for. I've had an 8 week ultrasound (abdominal and vaginal) and on the vaginal one, it was crystal clear. I could see a little baby with hands and legs and I could even see the indents where the eye sockets were. This was on a standard ultrasound machine, nothing fancy. I've also had one done previously with a pregnancy that wasn't viable at 8 weeks when baby measured only 5 weeks and even still was clear to see and she could get CRL measurements. There should be no reason she shouldn't be able to get a decent image vaginally at 8 weeks (unless the pregnancy was ectopic and wasn't actually in the uterus, which I assume has been ruled out if they can see a yolk sac there). I would push to go back for another appt with your OB and ask for a different person to do it, make the argument that you can't get an appt with the other place. Do you have another regular u/s scheduled sometime soon? I expect they would want to see you at 12 weeks anyway, but maybe you can argue for it sooner. A healthy heartbeat is a good sign, but I would personally be worried that she was picking up your heartbeat if she couldn't even manage to find baby very well. I'd be concerned she didn't really know what she was doing.

I agree with pp. Sounds like a problem either with the machine or with the technician. Did you hear the heartbeat yourself? If so, was it definitely baby's? If you're sure on that then I'd be reassured that it was potentially just a problem with the machine, but I can't understand why the tech wouldn't flag that up. Definitely ask for another scan. Whatever the purpose of that scan was, they didn't fulfil it, so if you needed one before then you still need one now, if that makes sense.

Here the people who do ultrasounds are trained technicians, and if they have a hard time seeing something or figuring something out, they bring in a more senior/experienced staff member into the room. I don't know anything about what an obstetrician does, but imagine it is more along the lines of a doctor crossed with a midwife? So I don't expect them to be a master of sonography.

The ultrasound was not done by a tech, it was done by my OB herself. The image was way off to the side of the screen, and she didn't even move the wand much. We could see the flickering heartbeat just barely, but as I mentioned, she couldn't find the fetal pole.

I did hear the heartbeat myself, and I'm certain it was the baby's. I compared my own heartbeat to it as we listened to make sure.

She did say it was a very old machine, too. I have to wonder why they keep it around, in that case! Women needing dating scans can't get accurate dates on dinosaur aged ultrasound machines!

I've had several calls back and forth with the specialty ultrasound dept, and it sounds like they can squeeze me into the schedule tomorrow instead of making me wait until Nov 30th.

Also - minties: you're correct, an obstetrician is sort of like a cross between a midwife and a gynecologist. They handle all prenatal care, gynecological care, AND labor and delivery.

Really glad you're getting a scan so soon. I hope you get good news. It's definitely promising that you heard baby's heartbeat - got to have been something wrong with the screen, it doesn't make sense that there was a heartbeat there but nothing visible. Update us if you can!

I came across sites a few years ago that talked about OBs purchasing U/S equipment to have in their office but aren't trained fully on them. It makes a huge difference in machine quality and tech ability. I'm glad to hear you can get in tomorrow.

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